An Updated Analysis of Recent Trends & Federal Expenditures Associated with Teenage Pregnancy
Teen pregnancy and birth rates have declined steadily in the United States in recent years. Experts attribute the declining rates to a substantial increase in contraceptive use by sexually active teens and to a decrease in sexual activity among adolescents.1 Despite these declines, the United States continues to have the highest teen birth rate among all industrialized nations anda higher teen birth rate than over 50 developing nations.2
Teenage pregnancy and childbearing have considerable, long-term consequences for teenage parents and their children. For example, research shows that when younger adolescents give birth, they are less likely to complete high school and more likely during their lives to have a larger number of children than are non-parenting teens. Children born to younger teen mothers may also experience poorer health outcomes, lower educational attainment, and higher rates of adolescent childbearing themselves when compared to children born to older mothers.3
Americans commonly believe that educational, social, medical, and economic difficulties experienced by adolescent mothers and their children are the consequences of teenage childbearing. However, research demonstrates that economic and social disadvantage is among the causes, as well as consequences, of teenage childbearing.4
Teenage pregnancy and childbearing also have substantial economic consequences for society in the form of increased welfare costs. Advocates for Youth estimates that in federal fiscal year 1996—the year for which the most recent data is available—the federal government spent over $38.0 billion to provide services and support to families that began with a birth to a teen. This includes families headed by adult females who were teenagers when they had their first child.
The federal government's financial support for teen pregnancy prevention initiatives pales when compared to this large expenditure. Advocates for Youth estimates that in federal fiscal year 1996, the federal government invested $138.1 million—less than one-seventh of one billion dollars to prevent teen pregnancy. That is more than 275 times less than the amount the federal government spent to support families begun with a birth to a teen.
Trends in adolescent sexual behavior are encouraging. However, pregnancy and birth rates among U.S. teens remain too high. Policy makers must not curtail support for families begun with a birth to a teen. However, to effectively reduce rates of unintended pregnancy and births among teens, the federal government should invest in teen pregnancy prevention initiatives. Moreover, these prevention funds must be invested in proven, scientifically evaluated programs which are effective in helping teens to delay the initiation of sexual intercourse and to practice safer sexual behaviors when they become sexually active. Such programs provide:
- Accurate, balanced, and realistic sexuality education
- Youth development
- Confidential and low-cost access to contraceptive services.
Research indicates that balanced, realistic sexuality education—which includes information on both abstinence and contraception—can delay teens' onset of sexual activity, increase the use of contraception by sexually active teens, and reduce the number of their sexual partners.5 Moreover, an overwhelming majority of Americans support providing sexuality education in junior and senior high schools. In particular, most Americans want students to have information about protecting themselves against unplanned pregnancy and infection with sexually transmitted diseases (STDs).6
Research shows that youth development programs can reduce sexual risk behaviors and teenage pregnancy.7 These programs are comprehensive and multifaceted. They build on the assets and strengths of young people and assist youth to define goals, complete school, and plan their futures. Youth development seldom tackles isolated problems—such as sexual risk behaviors—but focuses instead on providing holistic support and opportunities for young people. Youth development is a strategy that attempts to meet the needs young people themselves identify: to have life skills, to be cared for and safe, to be valued and useful, and to be spiritually grounded. It meets these needs by building on young people's capacities, assisting them to cultivate their own talents and to increase their feelings of self-worth, and easing their transition to adulthood.8
Access to Contraception
Making contraceptives available to youth also reduces adolescents' sexual risk behaviors. Confidential and low-cost contraceptive services ensure that sexually active teens have what they need to protect themselves and their partners from the risk of infection with HIV or STDs and unintended pregnancy. Research demonstrates that teenage women would experience an estimated 385,800 additional unintended pregnancies annually if publicly subsidized contraceptive services were not available. Therefore, publicly funded contraceptive services annually avert about 154,700 births, 183,300 abortions, and 47,800 miscarriages or spontaneous abortions among teens.9
Unfortunately, the limited funds that the federal government provides for teen pregnancy prevention are not always invested in scientifically evaluated strategies or programs that successfully reduce adolescent sexual risk behaviors and teenage pregnancy. Since 1981, the federal government has invested in the Adolescent Family Life Program which focuses on developing programs that promote abstinence as the only option to help young people avoid STDs, HIV, and teenage pregnancy. In 1996, the U.S. Congress enacted welfare reform legislation, Public Law 104-193, which funded a provision to support abstinence-only-until-marriage education that prohibits teaching about contraception beyond failure rates.10
The American public sees a strong distinction between abstinence and abstinence-only-until-marriage education. More than 90 percent of adults support abstinence being included as a topic in sexuality education for high school students. However, 70 percent of American adults oppose provision of federal law that allocates over half a billion dollars for abstinence-only-until-marriage education but prohibits use of the funds for information on contraception for the prevention of disease and unintended pregnancy.6
No research indicates that abstinence-only—also known as abstinence-only-until-marriage programs—are effective at reducing rates of teen pregnancy or birth. In fact, a team of researchers reviewed the evaluation of federally funded abstinence-only programs for adolescents. The researchers reported, We are not aware of any methodologically sound studies that demonstrate the effectiveness of curricula that teach abstinence as the only effective means of preventing teen pregnancy. … Additionally, there is mounting evidence suggesting that [abstinence-only] programs are generally ineffective.11*
In contrast, for every dollar spent to provide publicly funded contraceptive services, the government saves an average of three dollars in Medicaid costs for pregnancy-related health care and medical care for newborns.9 If the $2.5 million invested in fiscal year 1996 through the federal Adolescent Family Life (AFL) Program had been invested instead in contraceptive services for sexually active teens, the accrued savings would have totaled over $7.6 million.
This report underscores the need for U.S. policy makers to take pragmatic action to prevent teen pregnancy. Adolescents deserve effective strategies to prevent teen pregnancy and programs that are based upon the best practices as determined by evaluation and research. The U.S. federal government could make a difference in young people's futures by increasing its investment in effective programs.
* The abstinence-only-until-marriage strategy was not in effect for federal fiscal year 1996, the fiscal year discussed in this report. Nevertheless, it is noteworthy that the $50 million allocated to abstinence-only-until-marriage programs in federal fiscal year 1998 would have consumed 36 percent of the federal government's total investment in prevention strategies if this initiative had been in effect in fiscal year 1996.